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Abnormal invasion of the placenta

Tuba Gunel, Nilufer Kamali, Mohammad K Hosseini, Ece Gumusoglu, Ali Benian, Kilic Aydinli
PURPOSE: Preeclampsia (PE) is a pregnancy specific disease soon after 20 weeks of gestation where major symptoms are hypertension and proteinuria. The underlying pathology is believed to be abnormal placentation. Epigenetic and genetic factors have significant roles in abnormal placental development. MicroRNA's (miRNAs), being one of the most important epigenetic regulators, take part in abnormal placentation. Hsa-miR-195 is a molecule associated with abnormal placental growth mechanisms such as impaired cellular proliferation, inadequate trophoblastic invasion causing defective spiral artery remodeling and apoptosis...
August 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
Helena C Bartels, James D Postle, Paul Downey, Donal J Brennan
Background . Placenta accreta spectrum (PAS) is a condition of abnormal placental invasion encompassing placenta accreta, increta, and percreta and is a major cause of severe maternal morbidity and mortality. The diagnosis of a PAS is made on the basis of histopathologic examination and characterised by an absence of decidua and chorionic villi are seen to directly adjacent to myometrial fibres. The underlying molecular biology of PAS is a complex process that requires further research; for ease, we have divided these processes into angiogenesis, proliferation, and inflammation/invasion...
2018: Disease Markers
Nicole T Spillane, Stacy Zamudio, Jesus Alvarez-Perez, Tracy Andrews, Themba Nyirenda, Manuel Alvarez, Abdulla Al-Khan
BACKGROUND: The incidence of abnormally invasive placentation (AIP) is increasing. Most of these pregnancies are delivered preterm. We sought to characterize neonatal outcomes in AIP pregnancies. METHODS: In this retrospective case-control study (2006-2015), AIP neonates (n = 108) were matched to two controls each for gestational age, antenatal glucocorticoid exposure, sex, plurity, and delivery mode. Medical records were reviewed for neonatal and maternal characteristics/outcomes...
2018: PloS One
Oscar G W Wong, Claire L Yang Cheung, Philip P C Ip, Hextan Y S Ngan, Annie N Y Cheung
The placentas of Down syndrome (DS) pregnancies exhibit morphologic and functional abnormalities. Although the increase in dosage of certain genes on chromosome 21 has been associated with the DS phenotype, the effects on placenta have seldom been studied. Herein, we examine the expression of four dosage-sensitive genes (APP, ETS2, SOD1, and HMGN1) in normal and DS placentas. We demonstrated significant overexpression of amyloid precursor protein (APP) in DS placentas at RNA and protein levels by real-time quantitative PCR, Western blot analysis, and immunohistochemistry...
July 20, 2018: American Journal of Pathology
Robert A DeSimone, Wendy K Leung, Joseph Schwartz
The increasing incidence of placenta accreta has paralleled the rise in its greatest risk factor: cesarean delivery. In placenta accreta, the abnormal invasion of the chorionic villi into the myometrium prevents separation of the placenta at delivery, and the myometrium is unable to contract to prevent hemorrhage. Spontaneous uterine rupture and hemoperitoneum may also occur in the setting of placenta percreta. The average blood loss during a delivery complicated by placenta accreta is 2 to 5 L, compared to less than 0...
June 27, 2018: Transfusion Medicine Reviews
Jing Li, Zhongjun Ding, Yue Yang, Baohong Mao, Yanxia Wang, Xiaoying Xu
Pregnancy complications are associated with abnormal cytotrophoblast differentiation and invasion. Hydrogen peroxide (H2O2) is an important mediator of oxidative ischemia/reperfusion stress in the placenta. Lycium barbarum polysaccharides (LBP) have been demonstrated to counteract oxidative free radicals. The effects of LBP in trophoblast HTR8/SVneo cells injured with H2O2 were examined. A cell counting kit‑8 assay was performed to detect the effect of LBP at different concentrations on the proliferative ability of H2O2 injured trophoblast cells...
September 2018: Molecular Medicine Reports
Jelena Boekhoff, Birgit Arabin, Jens Figiel, Siegmund Köhler
AIM: Based on the recent FIGO recommendations, we wish to report on preservation of the uterus in a patient with placenta increta by applying the leaving the placenta in situ approach. METHODS: A 30-year-old gravida 2, Para 1 was referred at 25 + 5 gestational weeks due to a placenta previa bipartita increta diagnosed by transvaginal ultrasound, a history of a cesarean and vaginal bleeding. After informed consent, the parents opted for conservative treatment...
July 16, 2018: Journal of Maternal-fetal & Neonatal Medicine
Charis Bourgioti, Konstantina Zafeiropoulou, Stavros Fotopoulos, Maria Evangelia Nikolaidou, Aristeidis Antoniou, Chara Tzavara, Lia Angela Moulopoulos
OBJECTIVE: The objective of our study was to evaluate MRI diagnostic ability in predicting invasive placenta with extrauterine spread in high-risk gravid patients. SUBJECTS AND METHODS: Between March 2016 and June 2017, 49 patients (mean age, 35.7 years; mean gestational age, 32.5 weeks) with sonographically confirmed placenta previa underwent dedicated MRI. All MRI examinations were reviewed by two experienced radiologists prospectively. Intraoperative and pathologic findings were the standard of reference...
July 11, 2018: AJR. American Journal of Roentgenology
Amarnath Bhide, Arianna Laoreti, Andrea K Agten, Aris Papageorghiou, Asma Khalil, James Uprichard, Basky Thilaganathan, Edwin Chandraharan
INTRODUCTION: Ultrasound signs of abnormal placental invasion are subjective in nature. We tested the hypothesis that placental thickness in the lower uterine segment is increased when there is abnormally invasive placenta (AIP) in women with a low-lying placenta. MATERIAL AND METHODS: Retrospective analysis of data of placental thickness in women with ultrasound evidence of major placenta previa or a low-lying anterior placenta was done. The diagnosis of AIP was confirmed both intraoperatively and on histopathology for those managed by partial myometrial excision with uterine conservation or by hysterectomy...
July 6, 2018: Acta Obstetricia et Gynecologica Scandinavica
Ahmet Rıza Esmer, Reyhan Aslancan, Burak Teymen, Eray Çalışkan
Placenta previa percreta is a serious pregnancy condition that may cause massive bleeding. Life-threatening hemorrhage is commonly managed via cesarean hysterectomy or vascular ligations in order to preserve fertility. We present a case of bilateral external iliac artery thrombosis after pelvic compression and uterine devascularization due to placenta previa percreta. The patient had cesarean section due to ultrasonography and magnetic resonance imaging-diagnosed placenta previa percreta, and stated that she preferred a conservative approach rather than hysterectomy in a case of massive bleeding...
June 2018: Turkish Journal of Obstetrics and Gynecology
Hui Zhu, Linhuan Huang, Zhiming He, Zhiyong Zou, Yanmin Luo
INTRODUCTION: Estrogen-related receptor γ (ERRγ) and 17β-hydroxysteroid dehydrogenase type 1 (HSD17B1) have important roles in cell invasion and in the proliferation of many types of cancer cells. However, it remains unknown whether ERRγ and HSD17B1 contribute to abnormal placental structure and dysfunction which characterize fetal growth restriction (FGR). Therefore, the aim of this study was to investigate the expression profiles of ERRγ and HSD17B1 in placenta tissues affected by FGR and to examine a possible molecular mechanism by which ERRγ is able to regulate HSD17B1 during development of FGR...
July 2018: Placenta
Antonia Iacovelli, Marco Liberati, Asma Khalil, Ilan Timor-Trisch, Martina Leombroni, Danilo Buca, Michela Milani, Maria Elena Flacco, Lamberto Manzoli, Francesco Fanfani, Giuseppe Calì, Alessandra Familiari, Giovanni Scambia, Francesco D'Antonio
Purpose of the article. To explore the strength of association between different maternal and pregnancy characteristics and the occurrence of abnormally invasive placenta (AIP). MATERIALS AND METHODS: Pubmed, Embase, CINAHL databases were searched. The risk factors for AIP explored were: obesity, age >35 years, smoking before or during pregnancy, placenta previa, prior cesarean section (CS), placenta previa and prior CS, prior uterine surgery, abortion and uterine curettage, in vitro fertilization (IVF) pregnancy and interval between a previous CS, and a subsequent pregnancy...
July 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
Cong Wang, Weisheng Cheng, Qian Yu, Tian Xing, Shoubin Chen, Lei Liu, Li Yu, Jian Du, Qingli Luo, Jilong Shen, Yuanhong Xu
Toxoplasma gondii infection evokes a strong Th1-type response with interleukin (IL)-12 and interferon (IFN)-γ secretion. Recent studies suggest that the infection of pregnant mice with T. gondii may lead to adverse pregnancy results caused by subversion of physiological immune tolerance at maternofetal interface rather than direct invasion of the parasite. Genotype-associated dense granule protein GRA15II tends to induce classically activated macrophage (M1) differentiation and subsequently activating NK, Th1, and Th17 cells whereas rhoptry protein ROP16I/III drives macrophages to alternatively activated macrophage (M2) polarization and elicits Th2 immune response...
2018: Frontiers in Immunology
Christophe Desterke, Rima Slim, Jean-Jacques Candelier
INTRODUCTION: Hydatidiform mole (HM) is an aberrant human pregnancy with abnormal trophoblastic development, migration/invasion of the extravillous trophoblast in the decidua. These abnormalities are established in a hypoxic environment during the first trimester of gestation. METHODS: Using text mining, we identified 72 unique genes that are linked to HM (HM-linked genes) that we studied by bioinformatic analysis in publicly available transcriptomes of primary chorionic villous cells (cytotrophoblast, syncytiotrophoblast, extravillous trophoblast, and arterial and venous endothelial) isolated from normal placentas or established trophoblastic cell lines cultured under different oxygen concentrations...
May 2018: Placenta
Flavien Delhaes, Stephanie A Giza, Tianna Koreman, Genevieve Eastabrook, Charles A McKenzie, Samantha Bedell, Timothy R H Regnault, Barbra de Vrijer
Abnormal maternal lipid profiles, a hallmark of increased maternal adiposity, are associated with pregnancy complications such as preeclampsia and gestational diabetes, and offspring long-term metabolic health is impacted as the consequence of altered fetal growth, physiology and often iatrogenic prematurity. The metabolic changes associated with maternal obesity and/or the consumption of a high-fat diet effecting maternal lipid profiles and metabolism have also been documented to specifically affect placental function and may underlie changes in fetal development and life course disease risk...
May 26, 2018: Placenta
Mahmoud Thabet, Mohamed Sayed Abdelhafez, Emad Ahmed Fyala
Objective: To describe the use of intrauterine inflated Foley's catheter balloon for control of postpartum hemorrhage (PPH) during cesarean section (CS) in cases of abnormally invasive placenta previa aiming to preserve the uterus. Methods: Retrospective case-control study of the data of women who underwent elective CS on abnormally adherent placenta previa was carried out. Women in whom inflated Foley's catheter balloon was used for control of PPH during CS ( n  = 40) were compared with a control group of women who underwent elective CS by the same technique but without use of intrauterine catheter balloon ( n  = 38)...
June 2018: Journal of Obstetrics and Gynaecology of India
Thorsten Braun, Katharina Weizsäcker, Mustafa Zelal Muallem, Janina Tillinger, Larry Hinkson, Frederic Chantraine, Wolfgang Henrich
The number of pregnant women with abnormally invasive placenta (AIP) including clinical relevant placenta increta and percreta has markedly increased with a reported incidence of as high as one in 731, By 2020 in the United States, there will be an estimated 4504 new cases of AIP and 130 AIP-associated maternal deaths annually. The preoperative diagnosis and operative management of AIP is challenging. In a planned cesarean delivery, a vertical lower abdominal skin incision is widely used in order to have enough space to perform a hysterotomy above the cranial edge of the placenta to avoid significant fetal and/or maternal hemorrhage...
June 5, 2018: Journal of Perinatal Medicine
Guanglu Che, Yanyun Wang, Bin Zhou, Linbo Gao, Tao Wang, Fang Yuan, Lin Zhang
Preeclampsia is a pregnancy-related disease with increasing maternal and perinatal morbidity and mortality worldwide. Defective trophoblast invasion is considered to be a major factor in the pathophysiological mechanism of preeclampsia. Heparanase, the only endo- β -glucuronidase in mammalian cells, has been shown to be abnormally expressed in the placenta of preeclampsia patients in our previous study. The biological role and potential mechanism of heparanase in trophoblasts remain unclear. In the present study, stably transfected HTR8/SVneo cell lines with heparanase overexpression or knockdown were constructed...
2018: Disease Markers
S Zullino, T Simoncini
SSRIs are the first choice for the treatment of mood disorders during pregnancy and lactation. Despite the known side effects, the benefits/risks balance suggests their use. Hypertensive disorders of pregnancy (HDP) and Intrauterine growth restriction (IUGR) are the main vascular effects of these drugs, with mechanisms that involves endothelial dysfunction in feto-placental system. These data are supported by animal models, even if preliminary findings are not yet adequately supported by molecular and clinical data...
September 2018: Vascular Pharmacology
Giuseppe Cali, Francesco Forlani, Ilan Timor-Trisch, José Palacios-Jaraquemada, Francesca Foti, Gabriella Minneci, Maria E Flacco, Lamberto Manzoli, Alessandra Familiari, Giorgio Pagani, Giovanni Scambia, Francesco D'Antonio
INTRODUCTION: The aim of this study was to assess the diagnostic accuracy of ultrasound in detecting the depth of abnormally invasive placenta in women at risk. MATERIAL AND METHODS: Prospective longitudinal study including women with placenta previa and at least one prior cesarean delivery or uterine surgery. Depth of abnormally invasive placenta was defined as the degree of trophoblastic invasion through the myometrium and was assessed with histopathological analysis...
May 25, 2018: Acta Obstetricia et Gynecologica Scandinavica
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